A blog about the challenges of new motherhood, breastfeeding, attachment parenting, and baby-led weaning. An insight into a new mom's mind, and her daily challenges as she works to raise a Babe by Breast.

Monday, January 31, 2011

NOTE TO READERS: As always, these kind of posts stir many feelings in readers, particularly in those whom these issues have affected deeply. We all make the best decisions we can with the information we have at the time, but the issue of guilt always seems to arise with these kinds of articles. I urge you to move past the guilty feelings and really look at the valuable information contained within. As Maddy Reid said, “We cannot withhold facts for fear of offending, because the importance of the information outweighs people’s rights not to be challenged in their beliefs.”

Ah, the hot button issue. There has been a large kerfuffle of attention lately over the start-up of a new milk-sharing network on Facebook called Human Milk 4 Human Babies (Human Milk 4 Human Babies HERE). The brainchild of fierce Montreal lactivist Emma Kwasnica, Human Milk 4 Human Babies is a network run by merit of individual state, province, and country pages where moms or families who are having difficulty with milk supply can turn to other lactating mothers for donated milk to supplement or feed their children. Moms with oversupply provide the milk, and Human Milk 4 Human Babies provides the space. It is a good setup, with Human Milk 4 Human Babies administrators and creators putting emphasis on the need for informed choice. The FAQ on their page is thorough and provides information on flash-pasteurization, disease transmission, and obtaining medical history from potential donors. Soon after Human Milk 4 Human Babies emerged as a major player (and a major threat to the formula industry), many medical groups jumped to issue vehement statements to the media, with their focus being less about informed choice and more on fear-mongering. The response from Health Canada and the Canadian Paediatric Society has been extremely cautionary, focusing on the risks of breast-milk sharing and calling the practice "very dangerous".( See Story HERE) Health Canada states that “unprocessed human milk should not be shared.” (see Health Canada’s statement HERE)

Considering the rapid rise of popularity for informed milk sharing, it should come as no surprise that this spring Health Canada chose to revise and rewrite its existing infant feeding recommendations. What is shocking however, if that the new recommendations state that “Commercial infant formulas are the only acceptable alternative to breastmilk” (See full draft statement HERE). There is no mention of donor breastmilk, either through a milk bank or via less formal channels. In fact, not only is the option of donor breast milk completely ignored, but the make-up and risks of formula feeding are also completely absent. Instead a huge portion of the document focuses on what formula is, what it contains, what types are available, and how it should be prepared.

WHAT???

Not only are the risks of formula feeding skated over, but Health Canada spends more time discussing the benefits of bovine-based formula over soy-based formula than it does on the Ten Steps from the Baby-Friendly Hospital Initiative, an Initiative that is essential to boost and maintain breastfeeding rates in maternity wards.

Come on Health Canada! Doctors receive little to no breastfeeding training during their time in med school. If you are lucky like me, you find a doctor who did his residency in a breastfeeding clinic (and still needs some of the finer points explained to him). Doctors and nurses in Canada turn to Health Canada for their information on infant nutrition, and aside from people in my lucky situation, most doctors still believe that formula is an equal alternative to mommy milk, and shoddy documents like this do nothing to inform them of risks and facts about formula, which can then be passed to new moms. So, in light of this ridiculous oversight of real formula facts, and the (very mild) explanation of what formula is, I will give you an exposition on what formula is NOT. Much of the credit for this list goes to several lovely ladies from the facebook page, “Hey Facebook, Breastfeeding Is Not Obscene!” (namely, Elizabeth Anthes, Stephanie Knapp Muir, Jo Slamen, Emma Locker, Karen Coffman, Murielle Bourbao, Jennifer Dunston Lane, Kasey-Louise Traynor, Nicky Lawrence, Cheryl Giovenco, Barbara Rail, Lucy Fensom, and the lovely Alison Kennedy. Thanks ladies!)

1. Formula is not sterile.

Have you heard E. Sakazakii? It’s a pathogen commonly found in infant formula that can cause major illness for the baby if formula is not prepared properly. It is essential that all bottles, nipples, and equipment be sterilized before every feed, and that boiling water is used to make the infant formula. It’s not enough that the water be “sterile”, like the companies who make those huge containers of sterile water would lead you to believe. The water needs to be hot enough at the time you prepare the bottle to kill off potential pathogens like E. Sakazakii. This leads us to point two.

For those of us breastfeeding moms who have supplemented or used formula at any point, we fully understand the truth of this statement. It is a million times easier to NOT have to get up, walk to the kitchen, boil the water (to kill the E. Sakazakii), prepare the formula, and then rush back to the baby, while all the while he is shrieking at the top of his lungs to be fed. Nor is it easier to haul all the paraphernalia associated with formula-feeding. The bottles, the sterilizer, the container of powder (oh damn, it spilled AGAIN), not to mention where oh where in this stupid mall can I find a place to boil my water? Oh shoot, we’ve been here for 7 hours, and the pre-mixed formula I made is only good for 30 minutes at room temperature! I forgot my miniature cooler! (http://www.nestle.ca/en/FAQ/baby_nutrition_faqs.htm) It is so much easier, once the initial bumps of learning are past, to just roll over, pop out a breast, and go back to sleep, or to find a seat (or stand, if you are talented), lift your shirt slightly, and latch baby.

3. Formula is not cheap

Oh boy, is it ever not cheap! That fancy little can costs anywhere from $18 a week to $50 a week, if you need a special kind. Sometimes they come on sale, and lots of moms will stock up then. However, it is not widely known that you should not switch your baby from brand to brand unless it is medically indicated! Feeding a baby a new type of formula every week because there was a sale is not a medical reason. This is very hard on your baby’s gut. If you are formula feeding, you must pick a brand and stick to it, regardless of cost, unless baby becomes ill or rejects the brand and type you have chosen. With formula, bottles, nipples, and other gear, formula feeding can cost the average family around $3000 a year. Breastfeeding is cost-effective. It’s free. No, you don’t have to buy a pump. Have you heard of hand-expression? It works just as well (and in many cases, better than), and is entirely free.

4. Formula will not save you from “breastfeeding problems” like mastitis, engorgement, breast pain, and leaking

Regardless of whether you breastfeed or not, your milk will still come in, you will still get engorged, you may still get mastitis, and you will still need to buy breast pads and special bras. You will leak like mad. That milk has to go somewhere, and since the baby isn’t easing your pain, there will be several days to weeks of suffering while you wait for your milk to “dry up”. Just feed it to the baby. Breastfeeding can be rocky initially, after all, we are designed to learn breastfeeding by watching our mothers and other women breastfeed their children, and there have now been several generations where we lost that opportunity to formula feeding and “modesty” implements, like breastfeeding covers and super top secret nursing areas. (Please see Emma Kwasnica’s amazing note, Why SEEING Breastfeeding Is Important, My Personal Challenge To You) Breastfeeding should be easier, but it’s not. It’s now a learning curve. So let yourself learn, because after 3 months or so, it does become easy. Then formula feeding is not easier.

5. Formula batches and ingredients are not approved by the FDA or Health Canada

Formula is not a standardized product. Health Canada and the FDA inspect the factories where the formula is made, but the formula itself is not regulated. No one inspects individual batches, no one even regulates the ingredients to ensure the same cocktail is made up for every can, or every batch. Rather, the formula companies use whatever ingredients are available and cheapest at the time. So from batch to batch, the actual % of vitamins and content is different. (Jack Newman and Teresa Pittman, 2009 - Dr. Jack Newman's Guide to Breastfeeding - Toronto, Canada - HarperCollins Publishing) Health Canada and the FDA also leave it to consumers to report potential problems or dangers found in the formula can, such as the beetles found in Similac in 2009. Parents were reporting finding beetles for months before the FDA responded, and Similac issued a recall. Formula cans also contain bisphenol-A, or BPA, a controversial chemical that was declared toxic by Health Canada in October 2010. Despite the declaration, formula companies continue to line their cans with BPA. BPA can leech into the powdered formula and be absorbed by the infant in greater quantities than found in plastic bottles. (http://www.toxicnation.ca/node/142) For more information on formula ingredients not listed on the can, please see THIS GROUP.

Formula is a risky business, not just for baby, but for mom too. There is a lot of information readily available on these risks, but I encourage readers to visit INFACT Canada for a good resource on the risks of formula feeding to mommy and baby.

(Reference provided above at infactcanada.com)

8. Formula Is Not Safe Or Easily-Available During Natural Disasters

As demonstrated by the earthquake in Haiti last year, or the recent flooding in Australia, natural disaster can hit quickly and without warning. When this happens, moms can be stuck trying to feed an infant. Without a safe water source or access to sterilizing equipment, formula feeding is not safe for babies and children.

“When there is an emergency, the biggest danger to babies is the risk of dying as a result of diarrhoeal illness. Babies who are breastfed have a secure and safe food supply, they are not exposed to disease causing bacteria and parasites that can contaminate water supplies and they receive antibodies and other disease fighting factors that help to prevent and treat illness. They are protected from the worst of the emergency conditions. However, babies who are not breastfed are at great risk. In an emergency, food supplies are disrupted, there may be no clean water, overcrowding is often a problem and the health care system is likely to be stretched beyond breaking point. Outbreaks of diarrhoea are very common and spread easily in these circumstances. Babies who are not breastfed are very likely to contract diarrhoea-causing illnesses from unclean water and, with a weakened immune system and limited treatment, many will die."

9. Formula Additives Like DHA and ARA Do Not Make Formula “Like Breast Milk”

This one is pretty contentious. Formula companies rip off millions of people every year with their claims that they are closer/closest/the closestestestest EVER to breast milk. DHA and ARA are complicated fats that occur naturally in breast milk and help to build brain tissue. The DHA and ARA added to formula are not naturally occurring. They are extracted with hexane from algae grown in a lab, and then added to the formula. Not only does this allow traces of the neurotoxin hexane into the formula, it also allows the companies to charge exponential amounts of money for a product that has never been proven to actually do what breast milk fatty acids do. Their claims of brain growth are unsubstantiated and unproven, guys. If you are formula feeding, please don’t be taken in and buy the $40 can for the unproven hexane-riddled algae fat. The non-DHA/ARA stuff will serve your baby the same, cost you less, and potentially save them from ingesting trace amounts of a neurotoxin.

10. Formula Is Not A Safe Way To Make A Baby Sleep Through The Night, Babies Should Not Sleep Through The Night

When a new mom is struggling with sleep deprivation, and trying to figure out ways to catch some extra Z’s, she will often hear the refrain “Top him up with some formula, so he will sleep through the night”. This is a formula-feeding myth that we hear often as new moms, and even during our pregnancy. The idea that formula will make your baby sleep through the night is not true. Ask any formula-feeding mom of a four month old how many times they wake to give the bottle to a baby at night. Ask a co-sleeping, breastfeeding mom. She won’t be able to tell you, because she doesn’t wake up. A recent study found that breastfeeding co-sleeping moms get the most sleep of any moms, and are most rested. Not what you expected to hear? The idea that babies should sleep through the night is a fallacy. There are some major myths that need to be addressed here. First, babies are NOT biologically designed to sleep through the night! Oh yes, you heard me right. All those advertisements about night-time formulas, and magical sleeping tools, and magical sleeping babies are presented to make you buy a product that does not work, and that you should not be using in the first place, because it can endanger your baby’s life. Formula is difficult for a baby’s system to digest. The animal proteins linger in the lining of the stomach and intestines, and the ill-absorbed iron causes it to sit like a lump in the baby’s stomach for much, much longer than breast milk. This throws a newborn baby’s whole biologically perfect sleep/wake system out of whack. They will initially sleep longer and deeper, although that effect generally fades after a few months. Contrary to the belief that sleeping through the night is a good and even necessary thing however, it puts your baby at risk for SIDS. Formula fed babies are at a much higher risk for SIDS death in the first year of life than breastfed babies. Breast milk exits the newborn’s system quickly, causing them to wake every few hours. If a mom is breastfeeding and sleeping with the baby nearby (at least in the same room), she will wake as the baby wakes, put the baby to her breast, and promptly go back to sleep. These kinds of feeding/sleeping arrangements provide the best sleep for moms, and the normal feeding/waking patterns that a baby needs to avoid SIDS.

This one really bugs me. Babies are not dogs. They don’t automatically bond with whoever feeds them. They don’t ONLY bond with people who feed them. There are a million and a half ways for Daddy to bond with baby that doesn’t involve a bottle. Daddy can bathe, sing to, read to, wear, and cuddle his baby. Daddies who have breastfed babies are not any less close to their babies than dads who give bottles. Feeding can be a special time, and if you want to share that with Daddy while simultaneously breastfeeding, here is what I recommend. My husband and I would often sit together as I breastfed our daughter. He would sit in the corner of the couch with his legs spread out and his knees bent, and I would sit inside the circle of his arms and legs and feed Babe while he looked over my shoulder. She would gaze lovingly and adoringly into my eyes, and then switch her gaze to him and gaze just as lovingly and adoringly into his. At over a year old, Babe is a daddy’s girl. She is five minutes on the breast and off again like a shot. Books are brought to Daddy first to read (he does the character voices soooo much better than I do). Bath time is almost exclusively Daddy’s domain too, except when I take a bath with Babe. She is as closely bonded with her Daddy as I am, without having been bottle-fed by him. Breastfeeding together was a special time for the three of us, and he got to share in the experience without risking my milk supply, or feeding artificial milk.

This one seems to come up a lot too. “My doctor said my baby was allergic to my milk.” “My baby is lactose-intolerant and needed special formula.” “My baby would throw up my breast milk after every feeding.” This one is fairly personal for me. If you have read my Birth and Breast story, you know Babe has a severe milk allergy. She spent many miserable hours, days, and nights screaming her little head off, writhing from side to side in pain, and panicking doctors and nurses with her poor weight gain. The first thing that medical professionals will inevitably prescribe (with the exception of a golden few who actually research these things) is highly specialized, highly expensive infant formula. These formulas still contain the allergens that your baby is reacting to in your milk. The proteins that are causing the reaction are hydrolyzed, which means they are broken down into minute size so they will not stick in the baby’s intestine and cause a reaction, or as great of a reaction. The first problem is, the process of hydrolization also breaks down many other essential proteins and nutrients that are needed by your baby for optimal growth. The second problem is, the allergens are still present, and still causing your baby’s immune system to overreact. This continual exposure can worsen the allergy, cause asthma, or create autoimmune disorders. Did you know “Seven to eight percent of babies are allergic to cow's milk formula; 50 percent of these babies also are allergic to soy formulas, [and that] use of cow's milk is not recommended until after the baby is one year old [?] (http://www.infantfeeding.info/RisksofAF.htm)” For a baby who has milk or other sensitivities, the best solution is not a $60 can of nutrient-deficient hydrolyzed formula, but instead an adjustment to mom’s diet. Dr. Jack Newman has some fabulous information on foreign proteins in momma’s milk at Colic In The Breastfed Baby.

13. Formula Is Not Custom-Tailored For Your Baby And His Needs, It Is Not Living

There are hundreds of different types of formula, different brands, different flavours, age-specific formulas and so forth, but there is no ONE formula that is exactly made for your little baby. Formula is just that, a formula. It is a guess at what a baby might need at a certain age. Breast milk is tailored according to your baby’s age, health, needs, the time of day, and even the weather outside. It is tailored down to the minute in a feed, with certain fats appearing at certain times of the feed. It contains higher levels of immunities based on your child’s current state of health, and on how often they play in dirt on the floor. It is custom-tailored around their environment, with a higher water content on hot days, and higher fat content during cold days. The amount of fat in your breast milk depends on your baby’s gender, their genetic makeup, and their age. Formula is not that specific, and will never be able to gauge that level of specificity, because it is dead. Breast milk is a living thing.

14. Formula Is Not A Failure, Formula Does Not Mean You Can Never Breastfeed, Formula Is Not Your Only Option

Before making the switch to formula, please do your research. There is a lot of contradictory and wrong advice out there, and many of us make it worse by perpetuating myths about breastfeeding and formula feeding. Do your research ahead of time, don’t make the decision in the hospital delivery room. Attend meetings of your local breastfeeding support groups, read books by notable breastfeeding experts, explore your options. Understand that breastfeeding is a learning curve. Each baby is a new experience. You learn as your baby learns. It takes time, and more than time, it takes patience, namely with yourself. Know where your International Board Certified Lactation Consultants are (Find an IBCLC). Know what you will do in case of trouble. Learn, learn, learn. If you are on your second child, and couldn’t make breastfeeding work with your first, know that you aren’t a failure. Don’t be tripped up by your guilt and anger. Try again. Equip yourself. Don’t be afraid to read breastfeeding articles, don’t let yourself be restricted by guilt, anger or hurt. Forgive yourself. Forgive your body. You can try again. If you have given up on breastfeeding, and wish you hadn’t, you can relactate, if you wish to. If you feed a bottle of formula, there is going back. You can return to breastfeeding, if you so choose. Support is key. Here is a list of amazing internet resources that I turned to in times of breastfeeding trouble. I hope they help you as well. I also recommend calling your local La Leche League Leader, or IBCLC and asking for help if needed. You can do this. You are capable. Breathe in, breathe out. If it is done, if you are at the end of your breastfeeding journey, before you wanted to be at the end, make peace with yourself. You are loving and loved, regardless of how it all turns out.

(Reference: Life experience. Dude, there's no http at the front, but it is lot harder to obtain than by just clicking a mouse.)